Abstract People with HIV continue to experience HIV stigma. Quantitative data on HIV stigma perpetrated by healthcare providers of hospitals providing HIV care in high-income countries are limited. ...The aim of this study is to investigate factors associated with HIV stigma in Dutch healthcare settings from the healthcare providers’ perspective. We conducted a cross-sectional study using the questionnaire ‘Measuring HIV Stigma and Discrimination Among Health Facility Staff – Monitoring Tool for Global Indicators’ to assess HIV stigma among healthcare providers (n = 405) in two academic hospitals. Healthcare providers licensed to provide medical care were eligible for inclusion. The primary outcome was the self-reported prevalence of at least one manifestation of HIV stigma measured by six stigma indicators (four individual, two institutional). Secondary outcomes were the prevalence of HIV stigma per indicator, per occupation, per department, and factors associated with individual stigma indicators. HIV stigma was prevalent among 88.1% (95%CI 84.5% − 91.2%) of participants. Stigma was mostly driven by negative attitudes towards people with HIV and worry to acquire HIV. Multivariate analysis showed that several factors were associated with HIV stigma, including younger age, male sex, working at one of the surgical departments, and working as a nurse. Having received any training on HIV stigma and/or discrimination was associated with less HIV stigma among all indicators. In conclusion, HIV stigma is highly prevalent among Dutch healthcare providers. Targeted approaches, including training on HIV stigma and discrimination, are needed to reduce HIV stigma in healthcare and should, among others, focus on younger healthcare providers.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background. As a result of effective combination antiretroviral therapy (cART) and advanced supportive healthcare, a growing number of human immunodeficiency virus (HIV)–infected children survive ...into adulthood. The period of transition to adult care is often associated with impaired adherence to treatment and discontinuity of care. We aimed to evaluate virological and social outcomes of HIV-infected adolescents and young adults (AYAs) before and after transition, and explore which factors are associated with virological failure. Methods. We included 59 HIV-infected AYAs from the Netherlands who had entered into pediatric care and transitioned from pediatric to adult healthcare. We used HIV RNA load and cART data from the Dutch Stichting HIV Monitoring database (1996–2014), and collected social and treatment data from patients' medical records from all Dutch pediatric HIV treatment centers and 14 Dutch adult treatment centers involved. We evaluated risk factors for virological failure (VF) in a logistic regression model adjusted for repeated measurements. Results. HIV VF occurred frequently during the study period (14%–36%). During the transition period (from 18 to 19 years of age) there was a significant increase in VF compared with the reference group of children aged 12–13 years (odds ratio, 4.26 95% confidence interval, 1.12–16.28; P = .03). Characteristics significantly associated with VF were low educational attainment and lack of autonomy regarding medication adherence at transition. Conclusions. HIV-infected AYAs are vulnerable to VF, especially during the transition period. Identification of HIV-infected adolescents at high risk for VF might help to improve treatment success in this group.
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BFBNIB, NUK, PNG, UL, UM, UPUK
Abstract
During COVID-19 lockdown, the in-hospital number of HIV indicator conditions decreased disproportionally compared with other non–COVID-19 diseases, which was accompanied by reduced HIV ...testing rates, number and proportion of positive HIV tests, and new HIV referrals, with more late presentation after lockdown cessation, indicating a significantly impacted HIV care continuum.
During COVID-19 lockdown, the in-hospital number of HIV indicator conditions
decreased disproportionally compared to other non-COVID-19 diseases which was
accompanied by reduced HIV testing rates, ...number and proportion of positive HIV
tests, and new HIV referrals with more late presentation after lockdown
cessation, indicating a significantly impacted HIV care continuum.
Plasma-sprayed ceramic coatings of fluorapatite (FA), magnesiumwhitlockite (MW), and hydroxylapatite (HA), and noncoated Ti-6Al-4V alloy (Ti) implants were evaluated histologically and ...histomorphometrically in a goat animal study. Cylindrical Ti-6Al-4V plugs were plasma-spray-coated with FA, MW, and HA. Noncoated, grit-blasted Ti plugs served as controls. The plugs were implanted into the right femur and left humerus of 20 adult goats. The results were evaluated using descriptive histology and histomorphometry. The histomorphometry consisted of measurements of bone apposition and coating thickness. The results demonstrated that FA showed a high amount of bone apposition without signs of degradation or dissolution. MW showed considerable reduction in thickness and at 12 weeks an adverse tissue reaction. However, at 25 weeks the amount of bone apposition was significantly increased compared with the 12-week implants. HA revealed considerable and progressive reduction in thickness and at 25 weeks a lower amount of bone apposition than FA and MW. At 12 weeks the Ti implants did reveal bone apposition, although frequently localized fibrous tissue was visible. At 25 weeks the Ti implants did not differ in bone apposition from the HA implants. Further studies are necessary on the effect of degradation or dissolution of HA on the compatibility with bone.
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